Job Description: Oregon Health & Science University
Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.
PAS Resource Specialist
US-OR-Portland
Job ID: 2024-31933 Type: Regular Full-Time # of Openings: 1 Category: Professional Portland, OR (Downtown)
Overview
Managed Care Coordination:
Maintains current information on managed care insurance plans and serves as a liaison and information resources for physicians, nursing support staff, and coworkers, referring physician offices, OHSU Health Plan Office, patients, and insurance companies on authorization requirements per diagnosis and service. Serves as service area expert on ICD9 coding requirements and issues. Obtains managed care authorizations for all consultations, procedures, office visits, and care arrangements by scheduling appointments and contacting other ancillary and clinical services as needed. Applies problem solving and negotiating skills in resolving patient concerns and managed care related problems.
Customer Service / Point of Service Operations:
Provide the highest level of customer service to both external customers (patients and their families, referring providers, insurance carriers, etc.) and internal customers (OHSU health care providers and staff) that meet or exceed the service standards of the health care industry. This duty includes prompt and professional communication efforts, exemplary phone etiquette, face-to-face customer contact skills, high emotional intelligence including during stressful situations, utilization of available information technology, consistently following standard work, flexible coverage of internal service needs and the continuous application of process improvement methods and skills. Greets patients and, where appropriate, checks them in prior to being seen by clinical staff.
Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Checks patient account numbers and corrects any problems, seeking advice from Central Registration as required. Ensures that all appointment comment information is accurate and complete. Enters all information accurately into OHSU databases or into the medical record when necessary. Inspects insurance cards and/or authorization notices. Explains and satisfies any necessary patient signature requirements (including non-covered service forms).
Identifies and collects co-payments, provides receipts, and completes necessary accounting procedures as needed. Notifies clinical staff when patients arrive, monitors the length of patient wait times and intervene as necessary. Distributes medication lists to patients and prepares other duties associated to clinic as needed. Validates parking as needed.
Enrollment & Authorization:
Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. Obtains authorizations for clinical care, procedures, and laboratory studies. Enters all information accurately into OHSU databases or into the medical record when necessary. Follows up on pending authorizations until they are obtained.
Arranged Care:
Coordinate high volume of complicated patient care appointments, procedures, and infusion treatments as directed by physician and/or nurse staff; Uses EMR and other systems as needed for scheduling. Creates a medical record if needed. Provides personal reminders to patients about upcoming appointments. Serves as a liaison and information resource for physicians, and nursing support staff; Return patients messages (phone and/or electronic); Prepare and mail patient information packets; Direct patients to appropriate providers for other health care issues; Complete and route direct referrals to other clinical services; Enter patient information accurately into the electronic medical record when necessary. Maintains a service-based working knowledge of oncology practice. Obtains prior medical records and studies if appropriate. Arranges for wheelchairs, interpreters, or other assistive devices as necessary to support safe, high-quality care. Other duties as assigned.
Responsibilities
One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and may require experience obtaining managed care authorizations. OR
One and a half years of work experience in a high volume direct public contact position and 6 months experience in a medical office setting.
The candidate must have a thorough knowledge of PAS policies and procedures.
Candidates will have demonstrated advanced PAS user skills as well as extensive knowledge of integrated care at OHSU.
Knowledge and Skills Required:
Basic computer skills including word processing.
indows applications, on-line scheduling, and a preference for data-base skills.
Excellent verbal and written communications skills.
Strong customer service orientation.
Demonstrated effectiveness in confrontational customer interactions.
Qualifications
HS Diploma or advanced degree preferred.
Experience in a medical and/or oncology office setting.
Knowledge of Epic systems.
Knowledge of OHSU network systems, including Outlook and Microsoft Office products.
